Intraindividual Comparison of Contrast Media Concentrations for Combined Abdominal and Thoracic MDCT

Behrendt, Florian F.; Mahnken, Andreas H.; Stanzel, S.; Seidensticker, Peter; Jost, Edgar; Günther, Rolf W.; Mühlenbruch, Georg

doi:10.2214/ajr.07.3176

Cited by 34 publications

(37 citation statements)

References 30 publications

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“…Our results show significantly higher attenuation values for the 300 mgI/ml compared with the 370 and 400 mgI/ml contrast medium. Similar results have been reported previously in other, partly intra-individual, studies [7,[21][22][23]. A possible explanation for the observation of higher mean attenuation values for CM with lower iodine concentrations, especially during the early phase of the CT, is that flow characteristics differ because of viscosity.…”

Section: Discussionsupporting

confidence: 90%

Intra-individual comparison of different contrast media concentrations (300 mg, 370 mg and 400 mg iodine) in MDCT

et al. 2010

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Section: Discussionsupporting

confidence: 90%

Intra-individual comparison of different contrast media concentrations (300 mg, 370 mg and 400 mg iodine) in MDCT

et al. 2010

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“…Our data are in accordance with those of previous investigations in patients with or without cirrhosis [23][24][25] and support the notion that the total amount of iodine, and not the iodine delivery rate, is a major determinant of vascular and parenchymal enhancement during the hepatic parenchymal phase [26].…”

Section: Effect Of Contrast Materials Iodine Concentrations During LIVsupporting

confidence: 93%

Effect of varying contrast material iodine concentration and injection technique on the conspicuity of hepatocellular carcinoma during 64-section MDCT of patients with cirrhosis

Guerrisi

Marin

Nelson

et al. 2011

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Objectives: The aim of this study was to compare the intraindividual effects of contrast material with two different iodine concentrations on the conspicuity of hepatocellular carcinoma (HCC) and vascular and hepatic contrast enhancement during multiphasic, 64-section multidetector row CT (MDCT) in patients with cirrhosis using two contrast medium injection techniques. Methods: Patients were randomly assigned to one of two groups with an equal iodine dose but different contrast material injection techniques: scheme A, fixed injection duration (25 s), and scheme B, fixed injection flow rate (4 ml s 21). For each group, patients were randomised to receive both moderate-concentration contrast medium (MCCM) and high-concentration contrast medium (HCCM) during two CT examinations within 3 months. Enhancement of the aorta, liver and portal vein and the tumour-toliver contrast-to-noise ratio (CNR) were compared between MCCM and HCCM. Results: 30 patients (mean age 59 years; range 45-80 years; 16 patients in scheme A and 14 in scheme B) with a total of 31 confirmed HCC nodules were prospectively enrolled. For scheme B, the mean contrast enhancement of the aorta and tumour-to-liver CNR were significantly higher with HCCM than with MCCM during the hepatic arterial phase (+350.5 HU vs +301.1 HU, p50.001, and +7.5 HU vs +5.5 HU, p50.004). For both groups, there was no significant difference between MCCM and HCCM for all other comparisons. Conclusion: For a constant injection flow rate, HCCM significantly improves the conspicuity of HCC lesions and aortic enhancement during the hepatic arterial phase on 64-section MDCT in patients with cirrhosis. Along with MRI, multidetector row CT (MDCT) is the modality of choice for the diagnosis and follow-up of patients with hepatocellular carcinoma (HCC), as well as for tumour burden assessment. With the advent of volume MDCT, enabling the acquisition of 64 or more sections during a single gantry rotation, it has become possible to scan the entire abdomen with submillimetre section widths within a short scan time (less than 5 s for 300 mm of coverage). Although this technique has shown several advantages over conventional CT, including better discrimination between different circulatory phases, the potential for scanning during peak organ enhancement throughout the entire imaging volume and true isotropic CT data sets, it has raised considerable challenges for the design of scanning and contrast material injection protocols that are optimised for the detection of hypervascular HCC lesions [1]. Recent investigations have emphasised the importance of using test bolus or bolus-tracking methods to synchronise CT data acquisition with the peak tumourto-liver contrast for hypervascular HCC lesions [2,3]; however, the most effective contrast medium injection technique for maximising tumour enhancement during the narrow temporal acquisition of modern MDCT systems remains largely unexplored. Previous studies with early generation MDCT scanners reported conflicting results with varying volumes a...

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“…However, a study by Awai et al in abdominal CT, with a very similar set-up as the aforementioned study by Suzuki et al, did find a benefit for rapid administration of lower concentration contrast medium [19]. Also, a recent intra-individual comparison in combined thoraco-abdominal CT by Behrendt et al found a better enhancement in the thoracic vessels for contrast medium with a concentration of 300 mg I/ml compared with that with a concentration of 370 mg I/ml [20]. It is unclear why our study and the studies by Awai et al and by Behrendt et al did detect a difference in arterial enhancement in favour of the lower concentration contrast medium while the other studies did not.…”

Section: Discussionmentioning

confidence: 72%

Biphasic contrast medium injection in cardiac CT: moderate versus high concentration contrast material at identical iodine flux and iodine dose

et al. 2010

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ObjectiveTo prospectively investigate the influence of contrast material concentration on enhancement in cardiac CT by using a biphasic single-injection protocol.MethodsSixty-four-row multidetector cardiac CT angiography was performed in 159 patients randomised to a moderate or high contrast medium concentration. Contrast material injection included a first phase for enhancement of the coronary arteries and a second phase, at half the iodine flux, targeted at enhancement of the right ventricle. Contrast medium injection was followed by a saline flush. For both concentrations, injection duration (and thus total iodine dose) was adapted to the duration of the CT data acquisition and iodine flux was adjusted to patient weight. Attenuation was measured at various levels in the heart and vessels and the two concentrations compared, overall and per weight group.ResultsEnhancement of the aorta and left ventricle was significantly greater with the moderate than with the high concentration contrast medium. This remained true for the two higher weight groups. No difference was found in the lowest weight group or in the right ventricle and pulmonary outflow tract.ConclusionWith a biphasic injection protocol, enhancement of the aorta and left ventricle was weaker with the higher concentration of contrast material.

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Intraindividual Comparison of Contrast Media Concentrations for Combined Abdominal and Thoracic MDCT

Cited by 34 publications

References 30 publications

Intra-individual comparison of different contrast media concentrations (300 mg, 370 mg and 400 mg iodine) in MDCT

Intra-individual comparison of different contrast media concentrations (300 mg, 370 mg and 400 mg iodine) in MDCT

Effect of varying contrast material iodine concentration and injection technique on the conspicuity of hepatocellular carcinoma during 64-section MDCT of patients with cirrhosis

Biphasic contrast medium injection in cardiac CT: moderate versus high concentration contrast material at identical iodine flux and iodine dose

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